Lariam Tablets 8 to 19 tablets

How to take Lariam tablets

The recommended preventive dose of Lariam is one tablet of 250mg per week. It should be taken on the same day of the week, depending on the duration of stay in the malarial region.

• Start taking the tablet one week before arrival to the malarial area (prophylactic treatment)
• Take one tablet every week throughout your stay
• Continue taking the pill for four weeks after leaving the area (to inhibit the reproduction of parasites, if you have infected)

The dose to be taken is adjusted according to the bodyweight of the person.

• For adults weighing 45kg or more, the dose is one tablet per week.
• For adults or children weighing 31 to 45kg, the treatment is three-quarters of Lariam tablets.
• Adults or children weighing a range of 20 to 30kg should take half a pill once a week.
• Children weighing from 5 to 19kg should take a quarter of a tablet.

It is advisable to consult your doctor or pharmacist before taking the tablet to have a proper dose adjustment. Lariam should be taken with a glass of water or milk, preferably not on an empty stomach.

Some people can experience serious mental problems caused by Lariam and in these cases, Lariam should be replaced with another medicine to prevent malaria.

If you have any of the following side effects while taking Lariam, stop taking this medicine and contact your GP immediately:

Common (up to 1 in 10 people): 

• Depression
• Anxiety

Other malaria tablets side effects are possible, such as: 

Very common (more than 1 in 10 people): 

• Sleeping problems

Common (up to 1 in 10 people): 

• Feeling dizzy
• Headache
• Vision problems
• Vertigo
• Nausea and vomiting
• Diarrhoea
• Tummy ache
• Itching

People with the following disorders must consult their doctor to find out whether the Lariam is safe for them or not if they have:

• Heart disease
• Epilepsy
• Liver disease
• Diabetes
• Blood clotting problem
• Patients taking blood-thinning medicines such as warfarin, Coumadin, Jantoven etc
• People who have had blackwater fever, a severe malarial complication
• Vision problems
• Low blood glucose
• Inflammation of the lungs, also known as pneumonitis
• Neuropathy with signs, e.g pins and needs, numbness
• Blood or lymphatic disorder
• Kidney problems
• Heart problems, especially changes in heart rhythm
• Previously contracted malaria even though you were taking Lariam tablets for malaria prevention
• Experienced a mild to serious potential life threatening allergic reaction to Lariam or any of its ingredients

Important: Your heartbeat can slow to a dangerous level if Halofantrine, which also treats malaria, and Lariam is taken at the same time. You must not take Halofantrine if you are already taking or have taken Lariam within the last 15 weeks.

Speak to your doctor immediately if you are already being treated with Halofantrine, or you have been prescribed a course of Halofantrine.

Specific precautionary measures should be taken if you are suffering from any underlying health condition and should be consulted in detail with your doctor. Some of the conditions that can develop and maybe life-threatening are:

Anaemia

Lariam can cause a decrease in red blood cells to count. If the symptoms of low blood count like shortness of breath, feeling tired or pale skin appear then contact your health service provider.

Dizziness

In some patients’ dizziness and loss of balance can occur after the use of Lariam. If you are suffering from any such problem, then do not perform the tasks that require alertness like driving or operating machinery until you feel fit to do so.

Heart Problems

If you suffer from any kind of palpitation or irregular heartbeat, contact medical help as soon as possible to avoid any threatening situations.

Dose adjustment in some cases

The dose of Lariam must adjust in patients suffering from kidney or liver disorders. In such patients, the blood levels of the drug can rise more than usual and need a reduction or adjustment in the standard dose. Patients having kidney and liver disorders should not take medicine without consulting a doctor or pharmacist.

Mental Health Problems

Some psychiatric and nerve problems can occur in some people taking Lariam. In some cases, these effects sustain for 6 months, 1 year or sometimes remain permanently after the treatment with Lariam. Immediately consult the doctor if you are experiencing any of these issues.

Epilepsy

Lariam can increase the chances of seizure attacks in persons having a history of epilepsy. These patients should not use Larium to protect malaria and only use it for treatment when benefits are more than risks.

It is essential to talk to your doctor or pharmacist about any other medication that you are taking before starting Lariam. Particularly medicines can have a drug interaction when taken in combination with Lariam. Similarly, it is equally important to check the drug interaction between Lariam and to start any new medicine.

• Antiarrhythmics (drugs used in the treatment of irregular heartbeat)
• Antihistamines (cetirizine, loratadine, diphenhydramine etc.)
• Alcohol
• Antidepressants (citalopram, escitalopram, clomipramine)
• Other antimalarials
• Antipsychotics (thioridazine, haloperidol, amisulpride)
• Moxifloxacin
• Pentamidine
• Atomoxetine
• Beta-blockers such as atenolol
• Calcium channel blockers
• Crizotinib
• Digoxin
• Antipsychotic drugs like chlorpromazine
• Antifungals
• Antibiotics

It is better to seek advice from the doctor for safe use of medicines and all possible interactions of the Lariam.

Pregnant women are more at the stake of having malaria, so it is better to avoid the malarial region as a precautionary measure. The risk of stillbirth, miscarriage, and neonatal death increases if the expecting mother suffers from malaria. If it is unavoidable to go, then you should use repellents to avoid mosquito bites.

Regarding the safety of Lariam in pregnant women, it has not been completely established. However, Lariam may be approved when there is increased risk of medical problems due to malaria than any other threat associated with Lariam intake. As the safety of the drug has not been completely developed, women should use contraceptives to avoid pregnancy when they are on Lariam therapy and up to three months after stopping Lariam intake. If you are pregnant, then there is no reason to terminate the pregnancy.

Although a minimal amount of drug passes into the breast milk and is not dangerous for feeding infants, it is better to take your doctors’ advice if you are a nursing mother. A nursing mother should only take Lariam if its benefits outweigh any risk that is associated with the infant on breastmilk.

It is vital to consider that the amount of medicine passed in mothers’ milk is not enough to protect the baby against malaria. In case of need, the baby should be given its dose of Lariam to be protected against disease. Whereas if both mother and infant are taking Lariam, then the amount of drug passed in the infant should be closely monitored particularly in low weight babies.

• British National Formulary. (n.d.). Mefloquine. Retrieved August 26, 2024, from https://bnf.nice.org.uk/drugs/mefloquine/